Provider Demographics
NPI:1144524042
Name:NDIFOR, CAROLINE N (RN)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:N
Last Name:NDIFOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12236 MEADOW GRASS CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-6311
Mailing Address - Country:US
Mailing Address - Phone:805-907-0500
Mailing Address - Fax:
Practice Address - Street 1:12236 MEADOW GRASS CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-6311
Practice Address - Country:US
Practice Address - Phone:805-907-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health